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Title: Exposure to extreme heat events is associated with increased hay fever prevalence among nationally representative sample of us, Adults: 1997-2013

Author
item UPPERMAN, CRYSTAL - University Of Maryland
item PARKER, JENNIFER - National Center For Health Statistics
item JIANG, CHENGSHENG - University Of Maryland
item HE, XIN - University Of Maryland
item MURTAGUDE, RAGHURAM - University Of Maryland
item CURRIERO, FRANK - Johns Hopkins University
item JAPKOTA, AMIR - University Of Maryland
item Ziska, Lewis

Submitted to: Journal of Allergy Clinical Immunology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/8/2016
Publication Date: 3/1/2017
Citation: Upperman, C., Parker, J., Jiang, C., He, X., Murtagude, R., Curriero, F., Japkota, A., Ziska, L.H. 2017. Exposure to extreme heat events is associated with increased hay fever prevalence among nationally representative sample of us, Adults: 1997-2013. Journal of Allergy Clinical Immunology. 5:435-441.

Interpretive Summary: Warmer temperatures can affect plant flowering including when and how much pollen is released. This connection between temperature and pollen can, in turn, affect allergic diseases such as hay fever. At present hay fever affects 7.5% of US adults and costs the US economy over $11.2 billion/year in medical expenses. Recent studies suggest that extreme heat events will likely increase in frequency, intensity, and duration in coming decades. But it is unclear if extreme heat events are already associated with hay fever. We linked National Health Interview Survey (NHIS) data from 1997 to 2013 (N=505,386 respondents) with extreme heat event data, defined as days when the daily maximum temperature (TMAX) exceeded the 95th percentile relative to a 30-year reference period (1960-1989). We used logistic regression to investigate the associations between exposure to annual and seasonal extreme heat events and adult hay fever prevalence among the NHIS respondents. We observed that adult exposure to extreme heat events had a 7% increased odds of hay fever compared to those in the lowest quartile of exposure (Odds Ratios 1.07, 95% Confidence Interval: 1.02-1.11). This relationship was more pronounced for extreme heat events that occurred during spring season. Our data suggest that exposure to extreme heat events is already associated with increased prevalence of hay fever among US adults. This information will be of interest to weed scientists, public health care providers, scientists, NGOs and business.

Technical Abstract: Warmer temperature can alter seasonality of pollen as well as pollen concentration, and may impact allergic diseases such as hay fever. Recent studies suggest that extreme heat events will likely increase in frequency, intensity, and duration in coming decades. The overall objective of this study is to investigate if extreme heat events are associated with hay fever, which affects 7.5% of US adults and costs US economy over $11.2 billion/year in medical expenses. We linked National Health Interview Survey (NHIS) data from 1997 to 2013 (N=505,386 respondents) with extreme heat event data, defined as days when daily maximum temperature (TMAX) exceeded the 95th percentile values of TMAX for a 30-year reference period (1960-1989). We used logistic regression to investigate the associations between exposure to annual and seasonal extreme heat events and adult hay fever prevalence among the NHIS respondents. During 1997-2013, adult (18 yrs and older) hay fever prevalence among NHIS respondents was 8.43%. Age, race/ethnicity, poverty status, education, and sex were significantly associated with hay fever status. We observed that adults in the highest quartile of exposure to extreme heat events had a 7% increased odds of hay fever compared to those in the lowest quartile of exposure (Odds Ratios 1.07, 95% Confidence Interval: 1.02-1.11). This relationship was more pronounced for extreme heat events that occurred during spring season, with an evidence of exposure-response relationship (Ptrend <0.01). Our data suggest that exposure to extreme heat events is associated with increased prevalence of hay fever among US adults.